A urethral stricture is a narrowing of the urethra resulting in pain with urinating, bladder stone formation, urinary tract infection, and may lead to kidney damage. Urethral strictures may be post-procedural, instrumentation-related, or caused by injury, trauma, infection, radiation, and in many cases the cause is unable to be identified. Urethral strictures vary from short, soft narrowings of the urethra with minimal symptoms to panurethral, rigid strictures that require invasive reconstructive surgery or urinary diversion. Urethral strictures occur in a variety of places along the urethral lumen, largely depending on the cause of the stricture.
Treatment options include short-term balloon or rigid dilators, surgical excision of scar tissue with anastomosis, tissue grafting, or urinary diversion. Mechanical expansion is used in dilation of the strictures to soften the scar tissue and expand the urethral lumen diameter. Current practices perform expansion of the urethra to a fixed diameter or pressure over a short period of time. Other surgical specialties, such as plastic surgery, use techniques of tissue expansion over a longer duration (i.e. weeks to months). These techniques used over a longer time period increase tissue quantity and improve vascularity, resulting in healthier tissue with improved blood supply and less likely to reform scar. However, because the urethra is a necessary channel for draining urine from the bladder, the urethra cannot be completely obstructed for several weeks. Furthermore, if normal urethral tissue unrelated to the stricture is expanded for an extended period, damage to otherwise healthy urethral tissue may occur. If the tissue of the stricture is not treated, obstruction will remain.